Indocyanine Green and Breastfeeding

Summary of use during lactation

Data from one patient indicates that a low subcutaneous dose of indocyanine green is not detectable in breastmilk. The manufacturer reports 17 cases of indocyanine green use in lactating women with no reported adverse effects in infants. Indocyanine green appears to be acceptable during breastfeeding, but it should be used with caution, especially while nursing a newborn or preterm infant.

Drug levels in milk and infant serum

Maternal Levels. A nursing mother with lower limb lymphedema was given indocyanine green intradermally for lymphangiography. Although the dosage was not stated, the article referred to other papers that used 0.2 mL of a 0.25% solution of indocyanine green injected subcutaneously into both lower extremities, with detection by fluorescent imaging of lymphatic drainage channels using an infrared camera. The mother expressed milk approximately after imaging was complete at about 3 hours after the dose. Observation of the milk was performed with an infrared camera, which revealed no fluorescent enhancement of the milk.[1] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

The manufacturer reports 17 cases of indocyanine green use in lactating women with no adverse events observed in the breastfed infant.

Effects on lactation and breastmilk

Relevant published information was not found as of the revision date.

References

1. Sakai H, Tsukuura R, Kageyama T. Non-enhancement of the breast milk after subcutaneous indocyanine green injection: Is indocyanine green lymphography safe for breast-feeding patients? Microsurgery 2021;41:198-9.33398900 PubMed